The Republic of the Marshall Islands, an archipelago of low-lying coral atolls in eastern Micronesia, is one of four sovereign nations that may be rendered uninhabitable by climate change in the present century. It is not merely sea level rise which is expected to undermine life in these islands, but the synergy of multiple climatic threats (Barnett and Adger 2003). Rising oceans and increasingly frequent typhoons will exacerbate flooding at the same time that the islands’ natural protection—coral reefs—will die from warming waters and ocean acidification. Fresh water resources will be threatened by both droughts and salt contamination from flooding. Although the reaction of the coral atoll environment to climate change is uncertain, it is likely that the islands will no longer be able to support human habitation within fifty or a hundred years (Barnett and Adger 2003: 326)—quite possibly within the lifetimes of many Marshall Islanders living today. In the public imagination, climate change in vulnerable, remote locations is the intrusion of contamination into a formerly pristine environment, of danger into a once secure sanctuary, of change into a once static microcosm (see Lynas 2004: 81, 124). Archaeologists, of course, know better than this: every place has a history of environmental upheavals, and the Marshall Islands is no exception. Researchers agree that coral atolls are among the most precarious and marginal environments that humans have managed to inhabit (Weisler 1999; Yamaguchi et al. 2005: 27), existing only ‘on the margins of sustainability’ (Weisler 2001). The islands in fact only recently formed: while the reefs are tens of millions of years old, the islets that sit on them emerged from the sea only recently, probably around 2000 BP (Weisler et al. 2000: 194; Yamaguchi et al. 2005: 31–2), just before the first people arrived (Yamaguchi et al. 2005: 31–2). The new home that these early seafarers found was not so much an ancient safe haven as a fragile geological experiment—land whose very existence was tenuous long before humans were altering the global climate.
Feasibility and efficacy of a pilot family model of diabetes self-management intervention in the republic of the Marshall Islands
